Are You Chasing the Wrong End of Dientamoeba fragilis?

Ever feel like you’re chasing your own tail trying to treat & find the source of GIT parasites in some patients?! Well guess what, you just might be!

We’re seeing more & more patients test positive for Dientamoeba fragilis and increasingly patients struggling to eradicate it and prevent relapse. And then there’s Blastocystis hominis affected patients… and then those lucky enough to have both.

Well, while we might have been grouping D.frag together with B.hominis, being the two most common GIT parasites in humans, looking for what they share in common, they are worlds apart (we think!) in terms of how they are transmitted to humans.

Did you know that D.fragilis is in fact a fragile, little non-flagellated fella? That’s right, this seemingly stubborn parasite that may be the source of some people’s woes, can barely survive in the real-world. It needs a host. Most importantly it needs us! We’re the preferred host…oh and there that gorilla with D.fragilis who presented with IBS like symptoms that someone published a case report on!!! But other than that, there are not many species that are able to be infested with this parasite. And…in order for parasites generally to use the exceptionally well-traveled fecal-oral route (can we use another word here, people?!), the parasite must exhibit a viable cyst life-stage. And guess which fragile little non-flagellated fella, doesn’t?? Yup. Which begs the question of course…how are we picking these guys up? And for some patients…over and over and over again 🙁

D.fragilis has been talked about in scientific literature for over 100 years..but not enough. Authors of recent reviews, including this comprehensive Australian one, barely conceal their disgust at how little we have managed to elucidate about this highly prevalent and pathogenic (we can all almost agree now) parasite during that time. But you know what…the vectors (ie what brings them into our gut) for D.frag have been touted for half of that last century. It might be time for us all to catch up on some old news 😉

Are you seeing more and more cases of Dientamoeba fragilis? Is it increasingly recurring or altogether treatment resistant in some patients? Is that because this parasite is becoming more common in our external environment, our homes, our food, our water, or the result of the increased frequency and sensitivity of the stool tests are patients are undergoing? There’s yet another possibility you now need to consider: that the missinglink is another creepy critter acting as a vector…that until now we haven’t paid enough attention to. This missing piece of the ‘D.frag Why me? Why me, again?!’ puzzle can help you resolve the Dientamoeba and at the same time, provide a much broader more holisitic understanding of your patients’ additional multi-organism gut neighbourhood and their whole health burden.

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